While less people smoke now than in 1964, more work still needs to be done to reduce tobacco use.

This week marked the 50th anniversary of the U.S. Surgeon General’s landmark report announcing that smoking cigarettes causes serious diseases. Recent Surgeon General Regina Benjamin hosted a summit of former Surgeons General at Xavier University in New Orleans to discuss the leading cause of preventable death—smoking—and ways to keep young people from getting addicted. The topic is urgent as an overwhelming majority of smokers begin before the age of 25. Centers for Disease Control (CDC) and Prevention Director Thomas Frieden wrote in Journal of the American Medical Association article “Tobacco control progress and potential”: “Tobacco is, quite simply, in a league of its own in terms of the sheer numbers and varieties of ways it kills and maims people.”

50 years ago

Believe it or not, there was actually a time when physicians recommended that people take up smoking to calm their nerves. Then in 1964, Surgeon General Luther Terry shocked the nation by releasing the report Smoking and Health. The report declared that smoking was linked to lung cancer, chronic bronchitis, emphysema, coronary heart disease and low birth weight in newborns. The report recommended immediate remedial action. The news was so shocking that the report was released on a Saturday so the report wouldn’t disrupt the stock market.

Anthony Komaroff, M.D., Editor in Chief of Harvard Health Publications, was a young doctor at the time. He said in “Surgeon General’s 1964 report: Making smoking history,” in Harvard Health blog posted January 10, 2014: “I don’t recall hearing about any Surgeon General’s report before Dr. Terry’s 1964 report. In fact, I’m not sure at the time that I knew the U.S. had a Surgeon General. Since 1964, many Surgeon General’s reports have been issued, and many have received a lot of publicity. But probably no subsequent report has had as powerful an impact on the health of Americans.”

50 years since

In January 2014, the U.S. Department of Health and Human Services released a new report, The Health Consequences of Smoking—50 Years of Progress. In the last 50 years, 52 percent of smokers quit, and 8 million lives have been saved. Due to the decrease of smokers, average life expectancy has increased 2.3 years for men and 1.6 years for women. Smoking is banned in most public places, and the high taxes collected from the sale of a package of cigarettes go toward smoking cessation programs.

• Smoking kills 440,000 Americans per year, or 1,200 per day. Another 16 million suffer from smoking-related conditions.

• Each day, 3,200 young people under age 18 smoke their first cigarette, and another 2,100 youth and young adults become daily smokers.

Young adults feed the tobacco industry

Why do 42 million Americans still smoke? Benjamin noted that for every smoker who dies, two more take his place. The tobacco industry needs new smokers because so many of their customers die. According to the Surgeon General:

90% of smokers start before age 18

99% of smokers start before age 26

Benjamin’s conclusion? “So if we can just get our next generation to not take that first cigarette before the age of 26, they have less than 1 percent chance of ever starting. And we can make that generation tobacco-free,” she said in an interview with Debbie Elliott on NPR, “Why is tobacco still the leading preventable cause of death?” posted February 12, 2014.

Why are cigarettes still legal?

That’s a complicated question. The reason is a combination of ingrained cultural habit, the power of the tobacco industry, jobs lost if cigarette plants close, lawmakers afraid of the millions of constituents who smoke, memories of the failed Prohibition era and the debate between personal responsibility versus government mandate.

Do you think the government should outlaw smoking, or is it a matter of personal choice? Tell us in the comments.